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Schizophrenia, Paranoid Type
DSM-II For more information, see Schizophrenia This type of schizophrenia is characterized primarily by the presence of persecutory or grandiose delusions, often associated with hallucinations. Excessive religiosity is sometimes seen. The patient's attitude is frequently hostile and aggressive, and his behavior tends to be consistent with his delusions. In general the disorder does not manifest the gross personality disorganization of the hebephrenic and catatonic types, perhaps because the patient uses the mechanism of projection, which ascribes to others characteristics he cannot accept in himself. Three subtypes of the disorder may sometimes be differentiated, depending on the predominant symptoms: hostile, grandiose, and hallucinatory. DSM-III For more information, see Schizophrenia The essential features are prominent persecutory or grandiose delusions, or hallucinations with a persecutory or grandiose content. In addition, delusional jealousy may be present. Associated features include unfocused anxiety, anger, argumentativeness, and violence. In addition, there may be doubts about gender identity or fear of being thought of as a homosexual, or being approached by homosexuals. The impairment in functioning may be minimal if the delusional material is not acted upon, since gross disorganization of behavior is relatively rare. Similarly, affective responsiveness may be preserved. Often a stilted, formal quality, or extreme intensity in interpersonal interactions is noted. The onset tends to be later in life than the other subtypes, and the features are more stable over time. If a biologically related family member of an individual who has this subtype also has Schizophrenia, there is some evidence that the subtype of the relative will also be paranoid Diagnostic Criteria A type of Schizophrenia dominated by one or more of the following: # persecutory delusions # grandiose delusions # delusional jealousy # hallucinations with persecutory or grandiose content DSM-IV For more information, see Schizophrenia The essential feature of the Paranoid Type of Schizophrenia is the presence of prominent delusions or auditory hallucinations in the context of a relative perseveration of cognitive functioning and affect. Symptoms characteristic of the Disorganized and Catatonic Types (e.g., disorganized speech, flat or inappropriate affect, catatonic or disorganized behavior) are not prominent. Delusions are typically persecutory or grandiose, or both, but delusions with other themes (e.g., jealousy, religiosity, or somatization) may also occur. The delusions may be multiple, but are usually organized around a coherent theme. Hallucinations are also typically related to the content of the delusional theme. Associated features include anxiety, anger, aloofness, and argumentativeness. The individual may have a superior and patronizing manner and either a stilted, formal quality or extreme intensity in interpersonal interactions. The persecutory themes may predispose the individual to suicidal behavior, and the combination of persecutory and grandiose delusions with anger may predispose the individual to violence. Onset tends to be later in life than the other types of Schizophrenia, and the distinguishing characteristics may be more stable over time. These individuals usually show little or no impairment on neuropsychological testing or other cognitive testing. Some evidence suggests that the prognosis for the Paranoid Type may be considerably better than for the other types of Schizophrenia, particularly with regard to occupational functioning and capacity for independent living. Diagnostic Criteria A type of Schizophrenia in which the following criteria are met: A'''. Preoccupation with one or more delusions or frequent auditory hallucinations. '''B. None of the following is predominant: disorganized speech, disorganized or catatonic behavior, or flat or inappropriate affect. DSM-5 See Schizophrenia